HealthDay News — Researchers say they have found an association between moderate and severe psoriasis and chronic kidney disease (CKD).
In a matched cohort study in which treatment records were used to determine psoriasis severity, the likelihood of someone with severe psoriasis having incident CKD was nearly twice as high as someone with mild psoriasis (adjusted OR 1.93 versus 0.99), Joy Wan, MD, from the University of Pennsylvania in Philadelphia, and colleagues reported in BMJ.
The risk of CKD was independent of sex, age, cardiovascular disease, diabetes, hypertension, hyperlipidemia, use of nonsteroidal anti-inflammatory drugs, BMI, and duration of observation.
These results were confirmed in a nested cross-sectional analysis in which general practitioners assessed psoriasis severity based on body surface area affected.
In the cohort study, a total of 136,529 patients with mild psoriasis and 7,354 patients with severe psoriasis were matched to 689,702 unaffected patients. The data came from the The Health Improvement Network (THIN), an electronic health record database maintained by general practitioners in the U.K.
The nested study included 8,731 patients with psoriasis matched to 87,310 patients without psoriasis who participated in the Incident Health Outcomes and Psoriasis Events (iHOPE) study.
The researchers found that, in the cohort study, the adjusted hazard ratios for incident CKD were 1.05 in the overall psoriasis group, 0.99 for mild psoriasis and 1.93 for severe psoriasis. In the severe psoriasis group, age was a significant effect modifier, with age-adjusted hazard ratios of 3.82 for patients aged 30 years and 2.00 for those aged 60 years.
In the nested analysis, the adjusted odds ratios for CKD were 0.89 for mild psoriasis, 1.36 for moderate psoriasis, and 1.58 for severe psoriasis.
“Future studies are warranted to confirm our findings, determine the mechanisms mediating renal insufficiency in psoriasis, and examine the impact of treatment for psoriasis on the risk of chronic kidney disease,” the researchers wrote.